Effect of weight loss on recurrence of atrial fibrillation after ablative therapy: a systematic review and meta-analysis

Background: Landmark trials have shown superiority of ablative therapy over medical therapy in certain subpopulation with atrial fibrillation (AF). Previous studies have demonstrated an association between weight loss and reduced rates of recurrence of AF after ablation. The objective of this study is to determine if weight loss reduces the recurrence of AF after ablation.

Methods: An extensive literature search and systematic review of studies of weight loss on recurrence of AF after ablative therapy was performed. Risk ratio (RR) and 95% confidence intervals were measured for weight loss group versus control group in each study, and comparative analysis as well as subgroup analysis was made.

Results: Eight studies with a total of 1,425 patients were included. Overall, studies of patients who lost weight demonstrated lower recurrence of AF (RR 0.35; 95% CI 0.18-0.67). However, subgroup analysis of studies which included patients who lost ≥10% weight loss from baseline showed lower recurrence of AF (RR 0.18; 95% 0.03-0.89), whereas studies which included patients with <10% weight loss did not (RR 1.00; 95% 0.51-1.96). Studies of patients who had less than 12-month history of AF (RR 0.24; 95% CI 0.11-0.57) and those who lost weight prior to ablation (RR 0.40; 95% CI 0.20-0.79) also had lower recurrence of AF.

Conclusion: Weight loss is associated with lower long-term recurrence of AF after ablative therapy. Studies of patients with ≥10% weight loss, less than 12-month history of AF, and weight loss prior to ablation experience lower recurrence of AF.